Tuberculosis Co-infection and Associated Factors among People Living with HIV /AIDS Who are on Antiretroviral Therapy in Pastoral Community, Northeast Ethiopia. A Bayesian Analysis Approach

Abstract

: Tuberculosis is one of the major public health problems in Afar region where the majority of the population is pastoral. However, there are limited data and analyses upon which to guide public health interventions. Therefore, this study aimed to determine the prevalence of TB and its associated factors among people living with HIV in the pastoral community, Afar region, Northeast Ethiopia. A facility-based cross-sectional study was conducted on 443 participants selected by systematic random sampling technique. Bayesian multivariable logistic regression analysis was done and an adjusted odds ratio with its corresponding 95% credible interval was used to declare a statistical significance. The prevalence of TB-HIV con-infection was 26.7% [95% CI: (22.6%–31.2%)]. Patients without chronic diseases (AOR = 0.49, CI = 0.29–0.75) and who did not use substances (AOR = 0.44, CI = 0.29–0.64) were negatively associated with TB-HIV co-infection whereas living in rural residence (AOR = 2.93, CI = 1.55–5.08), having baseline CD4 count 200 to 499 cells/mm³ (AOR = 2.02, CI = 2.02–3.87), CD4 count less than 200 cells/mm³ (AOR = 11.23, CI = 6.09–18.73), and having a family size of greater than 5 (AOR = 3.36, CI = 1.49–6.62) were the positively associated with TB-HIV co-infection. The prevalence of TB-HIV co-infection was high in the study area. Residing in a rural site, using substances, having a chronic illness, having more than five family sizes, baseline CD4 count of 200 to 499 cells/mm³, and less than 200 cells/mm3 were factors that increase the probability of tuberculosis among people living with HIV. Thus, comprehensive interventions focused on the identified factors are recommended to decrease the burden of TB-HIV co-infection.

Keywords:

• Tuberculosis co-infection
• associated factors
• HIV
• Bayesian analysis approach
• pastoral community
• Northeast Ethiopia

PUBLIC INTEREST STATEMENT

Tuberculosis is one of the major public health problems in Afar region where the majority of the population is pastoral. Although several studies were conducted on TB-HIV co-infection in different parts of Ethiopia, there are no sufficient studies among the pastoralist community.

We have recently used a new statistical approach (i.e Bayesian analysis approach) to assess associated factors of TB-HIV coinfection. This research was conducted to determine the prevalence of TB-HIV coinfection and its associated factors in the pastoral community of Afar Regional State, Northeast Ethiopia. Therefore, this study provides important information to health-care professionals to give more attention and work on the factors that are responsible for TB-HIV coinfection. It would also be useful to input other researchers who want to conduct research in a similar area.

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Acknowledgements

We would like to thank Samara University, Afar regional health bureau and Dubti District General Hospital staff. We also thank the study participants, data collectors, and supervisors for their cooperation in the study.

Ethics approval and consent to participate

Ethical clearance was obtained from the Ethical Review Committee of the College of Medicine and Health Sciences (CMHS), Samara University via permission letter of CMHS/0133/2020. The letter was submitted to the concerned bodies. Oral informed consent was obtained from the patients before enrolment. Privacy and confidentiality were kept.

Authors’ contributions

SBA, EM, KU, HA, KU, FY, and AWT had substantial contributions to the conception, design, and analysis of this research. They were involved in the interpretation of data and drafted the manuscript. SBA revised and finalized the manuscript. All authors read and approved the final manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Availability of data and materials

The datasets used during the current study are available from the corresponding author on reasonable request

Consent for publication

Not applicable.

Additional information

Funding

No specific fund was received for this work.

Notes on contributors

Setognal Birara Aychiluhm

Setognal Birara Aychiluhm holds a Master of Public Health (MPH) in Biostatistics from University of Gondar. Currently, he is an Assistant Professor of Biostatistics in the Department of Public Health, College of Medicine and Health Sciences, Samara University, Ethiopia. He is a Coordinator of the Publication and Editorial Office of the University.

His research interests are maternal, neonatal and child health, biostatistical methods, and communicable and non-communicable diseases.

The current study is part of the team’s efforts to provide essential information on TB-HIV coinfection in pastoral communities.